The Domestic Violence Survey

The survey was written by a previous intern, comprised of 63 questions, some with at least 5 sub-questions--so it was about 100 questions long. Long and repetitive.
So, it's been revised-and here it is!
I'm really excited to go out and pilot the new version, I see a lot of potential for it, and it recently occurred to me that it is SO cool that in a few months I will have my own data...and that I can use my OWN data in my OWN papers!! Oh, Academia. How you surprise me.

SURYA Foundation

Survey on Domestic Violence

Demographic Data

1. Name and age
2. Residence
3. Profession
4. Marital status
1. If married, love marriage or arranged?
2. How long have you been married?
3. Joint or nuclear family?
5. Children
1. Age and gender

General Mental Well-Being

6. How much are the following statements applicable to you on a scale of 1 to 5? (1=totally not applicable; 2=not applicable; 3=neutral; 4=applicable; 5=totally applicable)
1. I feel at home in my house
2. I feel appreciated by my husband
3. I feel appreciated by my in-laws
4. I feel appreciated by my children
5. I am in control over my own health
6. I can make financial decisions
7. I have a good relationship with my husband
8. I have a good relationship with my in-laws
9. I have a good relationship with my children
10. I feel free to do what I really want

Husband

If a woman is not married, skip questions 7 to 26.

7. Do you have any problems with your husband?
8. Is your husband angry often?
9. What are the most common reasons over which he is angry?
10. Does he ever shout at you or call you names?
11. How do you respond when he shouts or calls you names?
12. Do you tell anyone about the shouting/name-calling?
13. Does he threaten you when he is angry?
1. What are the threats about? (i.e. dowry, baby boy, etc.)
2. How do you respond to these threats?

14. Does he hurt you? If so…
1. How does he hurt you?
2. How often does the hurting occur?
3. Is he always hurting you in particular moments, like after coming home from work, or late at night?
4. What is the reason for the hurting?
5. Do you think the hurting is justified?
6. How do you respond to him hurting you?
7. Do you tell anyone about the hurting?
8. Did you ever need medical attention after being hurt by your husband? If so…

i. Did you get the medical attention?

ii. Where did you go for the medical attention?

15. Does your husband ever complain to you about not doing a good job in housekeeping?
16. Does he ever complain about how you raise the children?
17. Does he ever complain that you ask for too much money?
18. Does he ever complain about your family?
19. Does he ever complain about the dowry?
20. Are there any other topics that he complains about to you?
21. How do you respond to these complaints?
22. Do you think these complaints are justified?

23. What is your husband’s profession?
24. Does he earn enough money?
25. Does your husband drink? If so…
1. Does he drink at home?
2. Does he come home drunk?
3. Do you know why he drinks?
4. Is he shouting, complaining, or hurting you more after drinking?
5. Is his drinking problematic? If so…

i. Have you or your husband ever asked for help for his drinking problem?

26. Does your husband like another woman? If so…
1. Does he know that you are aware of this?
2. Have you ever discussed this with him?
3. Do you ever fight about this (verbal and/or physical)?

In-laws/Parents

If the woman is not married, and still living at her parents’ home, ask questions 27 to 32 about her parents instead of her in-laws. If the woman is living in a nuclear family, skip questions 27 to 32.

27. Do you have any problems with your in-laws/parents? If so…
1. With whom do you have problems?
2. What are the problems about? (i.e. children, housekeeping, asking for too much money, personal character, dowry, etc.)
28. Do you think the basis for these problems are justified?
29. Does any one of your in-laws/parents shout at you or call you names? If so…
1. What are they shouting about or what names do they call you?
2. Do you tell anyone about the shouting/name-calling?
30. Does any one of your in-laws threaten you? (i.e. about the dowry or having a baby boy) If so…
1. How do you respond to these threats?
2. Do you think these threats are justified?

31. Does any one of your in-laws/parents physically hurt you? If so…
1. Who hurts you?
2. How do they hurt you?
3. How often does the hurting occur?
4. Are they always hurting you in particular moments, like after coming home from work, or late at night?
5. What is the reason for the hurting?
6. Do you think the hurting is justified?
7. How do you respond to them hurting you?
8. Do you tell anyone about the hurting?
9. Did you ever need medical attention after being hurt?

i. If so, did you get the medical attention?

ii. Where did you go for the medical attention?

32. Does any one of your in-laws/parents drink? If so…
1. Do they drink at home?
2. Do they come home drunk?
3. Do you know why they drink?
4. Is he/she shouting, complaining, or hurting you more after drinking?
5. Is his drinking problematic? If so…
6. Have you or your husband ever asked for help for his drinking problem?

Own Children

If the woman does not have her own children, skip question 33.

33. Do you have any problems with your children? If so…
1. What kinds of problems do you have?
2. How do you respond to these problems?
3. Do you think the basis for these problems are justified?

Help-seeking Behavior

34. Have you ever sought help for any of your family problems? If so…
1. What kind of help did you get? (i.e. medical, financial, counseling, psychological)
2. Where did you seek help?
3. How did you know about this person/organization?
4. Was the help useful?
35. Do you need any help right now for any current family problems?
36. Have you ever heard of the SURYA Foundation?
37. Would you accept help from SURYA in the future if you needed it?